Contrasting Effects of Spousal Education on Depressive Symptoms Among Korean Middle-Aged and Older Adults

Factors Influencing Frequency of Depressive Experiences Among Married Working Women in South Korea

Background/Objectives: This study aimed to identify the factors influencing and predicting the frequency of depressive experiences among married working women in South Korea in the post-COVID-19 period (2022-2023). It examines how alterations in circumstances and the complex difficulties encountered by this demographic group may have shaped their depressive experiences. Through a comparative analysis of the group reporting depressive experiences and the group reporting no depressive experiences, the study delineates the factors influencing depressive experiences within the former group and the predictive factors within the latter group. The findings offer a comprehensive understanding of the factors that may contribute to mental health outcomes within this population. Methods: This study utilized data from the ninth wave (2022-2023) of the Korean Longitudinal Survey of Women and Families, conducted by the Korean Women's Development Institute. The study included a total of 1735 participants. A zero-inflated negative binomial regression model was applied to analyze the frequency of depressive experiences and the influencing and predictive factors. Results: Among the participants, 38.9% reported no depressive experiences. The count model analysis revealed that subjective health status, physical activity, thoughts about husband, family decision-making, and work-family balance were significant factors associated with the frequency of depressive experiences. In the logistic model, key predictors for those without depression included the spouse's education, physical activity, satisfaction with the spouse's housework, and happiness with marital life. Conclusions: These findings provide essential empirical evidence for the development of targeted policies and interventions aimed at mitigating and preventing depression problem among married working women.

Association between cooking with solid fuels and depressive symptoms among middle-aged and older adults in China: The mediating effect of the residential environment

BACKGROUND

Depression is a common issue among elderly people in both developing and developed countries. Existing research indicates that cooking with solid fuels has a negative impact on the mental health of middle-aged and elderly people (aged 45 and older). However, the potential role of the residential environment in this process is not yet clear. Clarifying this issue may help identify effective interventions to improve public health for elderly people. This study aimed to explore the association between cooking with solid fuels and depressive symptoms, as well as the potential mediating role of the residential environment in this relationship.

METHOD

This study utilized cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) for 2020, involving approximately 19,000 respondents aged 45 years and older. Propensity score matching (PSM) was used to explore the association between cooking with solid fuels and depressive symptoms. Additionally, a range of potential covariates were adjusted, and the Sobel test was applied to assess the potential mediating effect of the residential environment on this relationship.

RESULTS

According to the fully adjusted model, cooking with solid fuels was significantly associated with an increased risk of depressive symptoms in middle-aged and older adults (β = 0.315, P < 0.001), and this finding was confirmed through robustness tests using different propensity score matching methods. Heterogeneity analysis revealed that this association was particularly significant among men (β = 0.318, P < 0.001), those aged 60-74 (β = 0.347, P < 0.001), and individuals with a middle school education (β = 0.353, P < 0.001). Mediation effect analysis revealed that indoor cleanliness (β = 0.0090, P < 0.001), indoor broadband coverage (β = 0.0077, P < 0.001), and the installation of indoor air purifiers (β = 0.0010, P < 0.1) mediated the relationships between cooking with solid fuels and depressive symptoms.

CONCLUSION

Given the growing attention given to improving indoor environments and enhancing mental health, the findings of this paper highlight that improving indoor cleanliness, increasing broadband coverage indoors, and installing air purifiers can effectively intervene in and prevent depressive symptoms caused by cooking with solid fuels.

Spousal education and frailty levels among Chinese older adults: A national longitudinal study

Background

Prior research has identified one's own education level as a risk factor for frailty. However, the association between spousal education and frailty in later life is uncertain. We aim to examine the longitudinal association between spousal education and frailty levels among Chinese older populations.

Methods

3856 participants aged 60 and older from the 2011-2018 China Health and Retirement Longitudinal Study were analyzed. A 54-item deficit cumulative frailty index was developed to evaluate frailty levels at each follow-up. Linear mixed-effects models were used to examine the longitudinal association of spousal education with frailty levels, and whether this association varied by sex and own education level.

Results

Higher spouse education was associated with lower frailty levels, and this association decreased with age. Compared with older adults whose spouses had no formal education, older adults whose spouses had less than middle school education had an 8.82 lower level of frailty (95% CI: 15.05 to -2.58, P < 0.01); those with spouses with middle school education and above had a 23.44 lower level (95% CI: 31.43 to -15.44, P < 0.001). Stratified analysis showed that every additional year of spouse education was also associated with lower frailty levels in non-frail participants at baseline, but stronger among those already frail. The association between high spousal education and lower frailty did not vary by sex or own education.

Conclusion

This study reveals a significant association between having a more educated spouse and lower later-life frailty levels for both older men and women, regardless of one's own educational background. It emphasizes the importance of leveraging educated spouses to prevent and manage frailty.

Declined prevalence, improved awareness and control of hypertension are associated with spousal educational attainment: A mega-data study

Cardiovascular diseases, including hypertension, have posed a serious threat to human health in recent decades. Family-centered health promotion and disease control for the management of hypertension is gaining attention. In this study, we assessed the association between spousal educational attainment (SEA) and hypertension prevalence, awareness, and control, intending to provide new directions for family health care. A total of 71 211 191 reproductive-aged participants from the National Free NFPCP during 2013-2019 were included in the current study. Inverse probability weighting (IPW) via propensity models were used to adjust for the imbalance by SEA. Both multivariable-adjusted ORs and inverse-probability-weighted ORs were used to assess the association between SEA and the prevalence, awareness, and control of hypertension. ORs of prevalence, awareness, and control of hypertension with SEA stratified by sex, age, and residency type were also reported. Compared with participants with SEA of compulsory education, the inverse-probability-weighted ORs for hypertension were 0.97 (0.96-0.97), 0.99 (0.98-1.00), and 0.91 (0.88-0.93) for participants with SEA of senior high, college, and postgraduate, respectively. The corresponding ORs for hypertension awareness were 1.12 (1.10-1.13), 1.15 (1.13-1.16), and 1.38 (1.34-1.41). The increment of hypertension control associated with SEA was only identified in urban areas. Modification analyses revealed that urban participants were observed to have more healthy benefits associated with SEA; additional decreased prevalent hypertension and increased hypertension awareness associated with SEA were observed in wives and husbands respectively. Thus, SEA was associated with decreased prevalent hypertension and increased awareness and control of hypertension. Our findings call for increased participation of spouses in family-centered healthcare, with consideration of modified effects by gender, age, and residency type, to improve chronic disease prevention and control including hypertension.

Spousal Educational Attainment and Sleep Duration Among American Older Adults

OBJECTIVES

Sleep has consistently been shown to have a dyadic nature among married older adults; however, less is known about the influence of a spouses' social characteristics on one's own sleep. Focusing on older adults, we examined the association between one's spouses' educational attainment and one's own sleep duration.

METHOD

We used the 2004-2018 National Health Interview Survey (NHIS) to analyze heterosexual married adults aged 50-84 (N = 89,180). Respondents reported typical sleep duration in a 24-hr period, which was categorized as short (≤6 hr), normal (7-8 hr), or long (≥9 hr). We fit multinomial logistic regression models predicting these categories of sleep duration and accounted for demographic, household socioeconomic characteristics, and health/health behaviors. Using interaction terms, we tested if the association varied by the respondent's gender and educational attainment.

RESULTS

Older adults married to spouses with college or more education had significantly lower relative risk of short sleep than those whose spouses had some college, high school, or less than high school education, net of the covariates including their own education. The benefit of higher levels of spousal education was significantly more protective against short sleep for women and more highly educated older adults.

DISCUSSION

Older adults married to spouses with high levels of education reported more favorable sleep durations, but this benefit was significantly stronger for women and the highly educated which has important implications for their aging. These findings suggest that social inequality may condition the dyadic nature of sleep for heterosexual married older adults.

The Association Between Spousal Education and Cognitive Ability Among Older Mexican Adults

OBJECTIVES

Education and cognition are closely associated, yet the role of spousal education is not well understood. We estimate the independent effects of own and spousal education on cognitive ability in late-life in Mexico, a developing country experiencing rapid aging.

METHOD

We analyzed 4,017 married dyads (age 50+) from the 2012 Mexican Health and Aging Study. Cognitive ability for married adults was a factor score from a single factor model. Using seemingly unrelated regression, we test whether spousal education influences older adults' cognitive ability, whether associations are explained by couple-level socioeconomic position, health and health behaviors, and social support, and whether associations differed by gender.

RESULTS

Education and cognitive ability were correlated within couples. Higher spousal education was associated with better cognitive ability. Associations between spousal education and cognitive ability were independent of own education, did not differ by gender, and remained significant even after adjustment for couple-level socioeconomic position, health and health behaviors, and perceived social support.

DISCUSSION

In addition to own education, spousal education was associated with better cognitive ability, even at relatively low levels of education. We discuss the possibility that spousal education may improve cognition via transmission of knowledge and mutually reinforcing cognitively stimulating environments.